Learn to Stack Like a Snowman

Learn to stack like a snowman….

The “stack” is one of the prerequisite positions to master in physical therapy or performance training. This position is essential for movements like squats, split squats, hip hinging and pretty much anything one might perform in the gym.

Think of the stack like a snowman. The 3 balls of a snowman represent the head (top ball), rib cage (middle ball), and pelvis (bottom ball). The goal of the stack is to center each of the 3 balls over one another.

The weight bearing surfaces of all 3 balls are larger when they are centered over one another. This means that the weight of the snowman is spread over a larger area (ie. less stress in each individual spot).

Now imagine that one ball starts to roll forward or backward. The ball above and below must roll with it to avoid falling to the ground and keep the snowman standing upright. This adjustment changes the weight bearing dynamics for each ball and more weight is now directed onto a smaller amount of space. This produces more stress onto these new weight bearing areas and may cause these areas to break down faster (think discs in our lower back).

This same dynamic happens in our body. As one of our balls (head, rib cage, or pelvis) rotates away from center, the other balls must accommodate. This places more stress onto the body as a whole and often results in discomfort.

Achieve the stack by practicing the following steps.

Imagine that you are wearing pants with back pockets. Without bending your knees further, roll your back pockets underneath your body (you should feel your abs turn on)
Without hunching over take a relaxed breath in, followed by a long and relaxed breath out. Feel your anterior ribs move down, back and in. Ensure that you can gently maintain this position while inhaling and exhaling
Imagine that someone is standing behind you pressing hard down onto your shoulders.

The stack can be a challenging position to master and integrate into your training routine. However it is often the secret to avoiding back pain with common activities in the gym.

Contact us to learn other adjustments to common exercises that may become your hidden secret to overcoming pain and optimizing your performance.

Why Powerlifters Don’t Move Laterally

As most physical therapists will tell you, powerlifters typically do not demonstrate great multidirectional movement skills. Why would they?

Training for any sport is all about specificity.

The goal of a powerlifter is to squat, deadlift or bench press more weight. Their training reflects this and as a result, they become better at those lifts. Any movement qualities that do not contribute to helping perform in these lifts are likely to suffer because they are not useful to the sport.

In fact, any unnecessary movement may be detrimental to their sport because it takes energy away from what is most important.

One way to prevent unnecessary movements from occurring is to reduce the capability of doing so in the first place!

Elite level powerlifters often do not even possess the prerequisite movement capabilities to efficiently move laterally. That wouldn’t be helpful to their performance!

The highest level of performance in any sport often requires physiological adaptations that set the body up for the greatest level of success in that specific activity. Many times, this means that unrelated movement capabilities will diminish.

While this is helpful for short term performance, when taken too far, a reduction in movement options can increase the risk for injury. A lack of movement capabilities results in a limited number of ways the body can minimize physical stress.

How do we know that the body has lost too many movement options? Overuse injuries begin to accumulate, and signs of discomfort start to present themselves.

The best solution for any athlete looking to improve their performance in particular sport is to visit a professional that can assess their capabilities and personal risk profile. Our team of Doctors of Physical Therapy at Cohen Health and Performance specializes in just that.

What Is That Hip Pinch?

Have you ever experienced an annoying “pinchy” sensation in the front of your hip? Many patients are referred to physical therapy for other regions of the body (back pain being the most common) and mention this uncomfortable sensation in passing.

Typically this occurs with movements like deep squatting. This “pinch” occurs as the ball of the hip (the femoral head) glides forward excessively and presses against the soft tissues located in the front of the joint.

This forward movement is normal however it is important be mindful of where the socket of the joint (acetabulum) is positioned as well.

Often times, pinching occurs in the front of the hip due to a poorly positioned hip socket.

The good news is that we can reposition the hip socket so that your hip does not pinch as easily!

There are many great drills that help with this however the Shifted Single Leg 90/90 Hip Lift is a great one to start with (this is also a great movement to get the hips/pelvis moving before running). In this video, the left hip socket is being oriented into a position that will result in less pinching.

Start by lying on your back with hips/knees bent at 90 degrees and feet on a wall
Slowly pull your heels down towards the ground as you reach your knees towards the ceiling. Your tailbone will slowly lift off of the ground and you should begin feeling your hamstrings working.
Without moving your feet, shift 1 hip/knee down as the other hip/knee shifts up. As you shift one hip/knee down, ensure that you are pulling towards the ground with that heel. You should feel that specific hamstring cooking at this point!
Pick the opposite foot up off the wall while maintaining the hip shift
Hold this position while taking a relaxed breath in through the nose, followed by a long exhale out through the mouth before pausing for 5 seconds. Perform this for 5 cycles.

As with all exercises, they should be specifically tailored to your particular needs and unique physical qualities. Schedule a FREE phone consultation with a member of our physical therapy team on our website to determine how to most effectively implement an exercise like this into your program!

How a physical therapist trains with back pain

Back pain is one of the most common issues encountered in sports physical therapy and injury rehabilitation, especially among runners. Those with sensitive lower backs often need to carefully manage the total amount of activity they perform over time.

It’s particularly important to pay attention to exercises that involve significant axial loading, which refers to weight bearing directly down onto the spine.

Exercises with high axial loading, such as barbell squats, typically involve supporting the weight on the shoulders.

For individuals with back pain, it’s crucial to keep the volume of axial loading reasonable. However, reducing the number of exercises that can be performed may limit progress for those who want to achieve their fitness goals.

The trap bar squat is an excellent exercise that targets the legs and, when executed correctly, keeps the back feeling great.

Here’s how to do it:

1. Set up a trap bar with a box placed in the center.
2. Stand on the box and position yourself inside the trap bar.
3. Exhale to engage your core by bringing the ribs down and activating your abs.
4. Inhale as you squat down by pushing your knees forward to reach the bar—this is not a deadlift!
5. If needed, reset your abs, take the slack out of the bar, and stand tall as you exhale.
6. Repeat.

What Touching Your Toes Really Says

Can you see the difference in these photos? The toe touch is a simple test that is often performed in injury rehabilitation and sports physical therapy settings.

However, important parts of this test are commonly missed. Simply touching your toes doesn’t tell the whole story. If you can touch your toes, great, however there are different ways that you can get there.

Have you stretched your hamstrings to such a degree that they allow you to nearly palm the floor?

If you are a gymnast that may be a great thing. However field sport athletes (ex. Lacrosse, football, basketball, baseball) and weight lifters need a level of hamstring stiffness for explosive movement.

Is your lower back straight or does it flex into more of a C curve to allow you to more easily touch your toes? Is your lower back bending in certain areas but not in others?

Your lower back consists of multiple bones (vertebrae) that are stacked on top of each other. Our backs are built this way to allow for movement of one segment on the next. However many times these small movements do not occur and the lower back moves as one unit. The result is a lower back that looks straight in places despite being bent over. Over time, a lack of lower back movement can increase the risk for injury.

The toe touch is a great test and can be made even better when directed by a professional with a trained eye.

Contact us for more information about how a customized movement assessment may help you optimize your training and avoid injury!

I felt stuck

Times have certainly changed, haven’t they? Just look at all that hair! And it seems like they couldn’t do much about the sun glare on picture day either…

“I really need to stretch more. Should I try Yoga?”

“Everyone’s talking about how Pilates strengthens your core. Maybe I should take a class?”

“I know strength training is crucial, but where do I even begin?”

If you’ve ever had thoughts like these when thinking about exercise, you’re not alone.

The world of health, fitness, sports physical therapy, and injury rehabilitation can feel massive and even a bit daunting. I remember a time when I was unsure about how to approach my own fitness journey.

After wrapping up my college football career, I no longer had coaches designing my training plans. No more structured practices, conditioning workouts, weightlifting sessions, or recovery routines that typically involved stretching, foam rolling, yoga, and light cardio.

With no clear direction, I stuck with what I knew best: lifting weights, following my old off-season routine, and adding a couple of conditioning sessions each week.

After a few weeks of this, I stopped and asked myself a simple but important question: “Why?”

Why was I training this way? What were my goals now? And what were the most effective ways to achieve them? After reflecting and writing down my thoughts, I realized that my training program no longer aligned with my new goals.

My football days were behind me, and it was time to focus on staying healthy long-term.

At the same time, I still enjoyed strength training and the feeling of being strong. Plus, I was working toward becoming a Certified Strength and Conditioning Specialist (CSCS), so I needed to practice what I preached (this was all before I entered sports physical therapy school).

I ultimately designed a new strength training program that focused on increasing strength and muscle mass while also enhancing my mobility. The goal was to feel strong and stay healthy.

This approach worked because I took a moment to slow down and ask myself a few basic questions.

When was the last time you did that? Ask yourself these questions:

– What are the outcomes I want from my training? Do I want to be stronger? Have less discomfort? Improve my mobility? Be honest with yourself.
– What are the best methods to achieve these outcomes?
– If I don’t know the answer to the above, who can help guide me?

As question three suggests, you don’t need to figure it all out on your own. There are experts available who can help you reach your goals, but only you can determine what those goals are.

Once you have that clarity, our team of sports physical therapists in Bethesda and McLean is here to help. Along with being Doctors of Physical Therapy, our Performance Physical Therapists are also Certified Strength and Conditioning Specialists. We specialize in helping injured athletes recover and get back to doing what they love.